Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis

Objectives It is unclear what is driving rising colorectal cancer (CRC) treatment costs in China, whether an adjustment in drug prices changes use and total cost. This study aims to estimate trends in drug use, prescribing patterns and spending for antineoplastic drug therapies for CRC in major citi...

وصف كامل

التفاصيل البيبلوغرافية
الحاوية / القاعدة:BMJ Open
المؤلفون الرئيسيون: Lingyan Yu, Wei He, Ying Yuan, Difei Yao, Yangmin Hu, Huimin Xu, Haibin Dai
التنسيق: مقال
اللغة:الإنجليزية
منشور في: BMJ Publishing Group 2021-10-01
الوصول للمادة أونلاين:https://bmjopen.bmj.com/content/11/10/e046166.full
_version_ 1849884571186757632
author Lingyan Yu
Wei He
Ying Yuan
Difei Yao
Yangmin Hu
Huimin Xu
Haibin Dai
author_facet Lingyan Yu
Wei He
Ying Yuan
Difei Yao
Yangmin Hu
Huimin Xu
Haibin Dai
author_sort Lingyan Yu
collection DOAJ
container_title BMJ Open
description Objectives It is unclear what is driving rising colorectal cancer (CRC) treatment costs in China, whether an adjustment in drug prices changes use and total cost. This study aims to estimate trends in drug use, prescribing patterns and spending for antineoplastic drug therapies for CRC in major cities of China.Methods Information from 128 811 antineoplastic drug prescriptions in CRC was retrospectively collected from the Hospital Prescription Analysis Cooperative Project. The prescriptions extracted included demographic information of patients, the generic name and the price of antineoplastic drugs. The Mann-Kendall and Cochran-Armitage trend test was used to estimate the trends of antineoplastic agent usage.Results The number of antineoplastic prescriptions ranged from 18 966 in 2015 to 34 219 in 2019. Among the prescriptions collected in this study, the annual cost of antineoplastic drugs increased by 117.2%, and average prescription cost increased by 20%. Throughout the study period, the most prescribed antineoplastic drugs were capecitabine, oxaliplatin, fluorouracil and irinotecan, representing 49%, 27%, 21% and 9% of (per cent of visits (PV)). The PV of bevacizumab and cetuximab increased by 494% and 338% (from 1.8% and 1.3% in 2015 to 10.7% and 5.7% in 2019). In prescribing patterns of antineoplastic agents, monotherapy gradually decreased, while combination therapy, especially three-drug combination, increased significantly from 1.35% to 7.31%.Conclusion This study estimated recent trends of antineoplastic drug use and expenditure for Chinese patients with CRC. These results would inform CRC treatment decisions, including health insurance negotiation, precision therapy access, allocation of research funding and evaluation of the financial burden of CRC drug treatment.
format Article
id doaj-art-3522a1cf5ba746d2a5f5451be01ac2d0
institution Directory of Open Access Journals
issn 2044-6055
language English
publishDate 2021-10-01
publisher BMJ Publishing Group
record_format Article
spelling doaj-art-3522a1cf5ba746d2a5f5451be01ac2d02025-08-20T01:07:30ZengBMJ Publishing GroupBMJ Open2044-60552021-10-01111010.1136/bmjopen-2020-046166Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysisLingyan Yu0Wei He1Ying Yuan2Difei Yao3Yangmin Hu4Huimin Xu5Haibin Dai6Pharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaEpigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, Texas, USADepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USAPharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaPharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaPharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China1 Department of Pharmacy, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, ChinaObjectives It is unclear what is driving rising colorectal cancer (CRC) treatment costs in China, whether an adjustment in drug prices changes use and total cost. This study aims to estimate trends in drug use, prescribing patterns and spending for antineoplastic drug therapies for CRC in major cities of China.Methods Information from 128 811 antineoplastic drug prescriptions in CRC was retrospectively collected from the Hospital Prescription Analysis Cooperative Project. The prescriptions extracted included demographic information of patients, the generic name and the price of antineoplastic drugs. The Mann-Kendall and Cochran-Armitage trend test was used to estimate the trends of antineoplastic agent usage.Results The number of antineoplastic prescriptions ranged from 18 966 in 2015 to 34 219 in 2019. Among the prescriptions collected in this study, the annual cost of antineoplastic drugs increased by 117.2%, and average prescription cost increased by 20%. Throughout the study period, the most prescribed antineoplastic drugs were capecitabine, oxaliplatin, fluorouracil and irinotecan, representing 49%, 27%, 21% and 9% of (per cent of visits (PV)). The PV of bevacizumab and cetuximab increased by 494% and 338% (from 1.8% and 1.3% in 2015 to 10.7% and 5.7% in 2019). In prescribing patterns of antineoplastic agents, monotherapy gradually decreased, while combination therapy, especially three-drug combination, increased significantly from 1.35% to 7.31%.Conclusion This study estimated recent trends of antineoplastic drug use and expenditure for Chinese patients with CRC. These results would inform CRC treatment decisions, including health insurance negotiation, precision therapy access, allocation of research funding and evaluation of the financial burden of CRC drug treatment.https://bmjopen.bmj.com/content/11/10/e046166.full
spellingShingle Lingyan Yu
Wei He
Ying Yuan
Difei Yao
Yangmin Hu
Huimin Xu
Haibin Dai
Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis
title Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis
title_full Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis
title_fullStr Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis
title_full_unstemmed Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis
title_short Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis
title_sort antineoplastic prescription among patients with colorectal cancer in eight major cities of china 2015 2019 an observational retrospective database analysis
url https://bmjopen.bmj.com/content/11/10/e046166.full
work_keys_str_mv AT lingyanyu antineoplasticprescriptionamongpatientswithcolorectalcancerineightmajorcitiesofchina20152019anobservationalretrospectivedatabaseanalysis
AT weihe antineoplasticprescriptionamongpatientswithcolorectalcancerineightmajorcitiesofchina20152019anobservationalretrospectivedatabaseanalysis
AT yingyuan antineoplasticprescriptionamongpatientswithcolorectalcancerineightmajorcitiesofchina20152019anobservationalretrospectivedatabaseanalysis
AT difeiyao antineoplasticprescriptionamongpatientswithcolorectalcancerineightmajorcitiesofchina20152019anobservationalretrospectivedatabaseanalysis
AT yangminhu antineoplasticprescriptionamongpatientswithcolorectalcancerineightmajorcitiesofchina20152019anobservationalretrospectivedatabaseanalysis
AT huiminxu antineoplasticprescriptionamongpatientswithcolorectalcancerineightmajorcitiesofchina20152019anobservationalretrospectivedatabaseanalysis
AT haibindai antineoplasticprescriptionamongpatientswithcolorectalcancerineightmajorcitiesofchina20152019anobservationalretrospectivedatabaseanalysis